HomeMy WebLinkAboutZ-10660FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Buildin§ Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the building ................................................
Location of Property ...2.5.0.5..lq.a.~y.'.~..R. 9.a.d., ........ N..a.i;.t:.t..t;99.k' ~ New York
House No. Street ................ ~l~r~l'e~
County Tax Map No. 1000 Section ...]..0.7. ...... Block ...09 ........... Lot ....0.2.q-.0..2.1 ......
Subdivision, .t:t.a.~.~.~..l;.u.c.k..}t..~.J.~h..~0 .......... Filed Map No. ! .1.8.4 .... Lot N~6r?.7.-..4.8 ......
, RqqujLr~mezl. t;s_f.O~ a_One.--Fam;[ldr .12~,eJ, lio& B~tJ, lt.. P. rJ.o_v t,o
conforms substantially to
Ce t, J.c t,e Occupancy
of the applicable provisions of the law. The occupancy £or which this certificate is issued is .........
The certificate is issued to He].en ~. Co~nJ. akey ........................
..................... ?°'wn'erx~:e~t~tXXX ..........
of the aforesaid building.
Suffolk County Department of Health Approval
UNDERWRITERS CERTIFICATE NO. ~/R
/
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
Location
Subdivision /~/~-~- /~_~c~/~ Map No. //~-~
Name of Owner(s) ?3~/Z=?~/
/
HOUSING CODE INSPECTION REPORT
(number & street) (Municipality
Lot(s)
Occupancy(typ/~--e(; g"~"~(owner-tenant)~
by: ~-~_;= Accompanied by:
Admitted
Key available ~/~c ~/~.-c~, Suffolk Co. Tax No.
ouroe r
DWELLING:
Type of construction
Foundation ~~~c/~-- Cellar~-~// Crawl space/
Total rooms, 1st. F1 ~ ~. 2nd. Fl~3rd. F1
Bathroom(s)
Porch, type~/~9
Breezeway
Type He at~7-~
#stories'-~)~
Toilet room(s)
Deck, type Patio, type__
Garage, ~ Utility room
Warm Air~__c~Hotwater
Fireplace(s) '" No. Exits 7~ Airconditionin~
Domestic hotwater ~'~ ~YPe heater ~/~_~//~
Other
ACCESSORY STRUCT~ES: ~ ~_
Garage, type const.~~ Storage, type const.
Swiping pool Guest, t~e const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location Description Art. Sec.
~~ ~,~- ~,,~7 ~z.~ ~,~e ~ ~z-~-
Remarks:
I s eo' e
Date of Insp.
Time start~:Ya/-/~ end
"Celic Real Estate in
Mattituck can give
you access to property.
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2, Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3, Copy of certificate of occupancy $1.00
$5.00
Date
New Building . . .~,.~;~,~... Old or Pre-existing Building .... ~. ....... Vacant Land .............
Location of Property ..... N. 9,r~. '.s., .Rp.a:.~ ................... .M.a.t.t..i.t.u.q~. ...................
House No, Street Hamlet
Owner or Owners of Property .E.s.~.a..t.e, .o.~..~.e.~.e..~. ~ ....C.o.~.:J:.s..~.ey. ...........................
020.000
County Tax Map No. 1000 Section . .~.0.7.: .0.0 ....... Block .... .0.9...0.0. ..... Lot,...0.2.1...0. 0..0 .....
Amended Map of
Subdivision .Ma~c~cituc.]~ 'Heights ............ Filed Map No...~.];.8..4 .... Lot No..4.6.,.~..&..~8..
Permit No ........... Date of Permit .......... Applicant ...............................
Health Dept. Approval ........................ Labor Dept. Approval .................. '
Underwriters Approval
........................ P'anning Board Approval ............. ~' ' ~Z'~
Request for Temporary Certificate ..................... Final Certificate .
Fee Submitted $ 5.00
Construction on above described building a~L,permit meets, al~plicable codes and regulations.
Applicant .tO .~.~...~..~:,.¢...(~/ ..............
eter S. DAnowski, Jr., AttOrney for Estate
Rev. 10-10-78 of Helen W. Comiskey
STATE OF NEW YORK )
) ss.:
COUNTY OF SUFFOLK )
CARL H. SCHNEIDER, Executor of the Estate of HELEN W.
COMISKEY, residing at 18 West Halleck Street, Riverhead, New York,
being duly sworn, deposes and says:
1. That the subject premises located at Mary's Road,
Mattituck, New York, are the subject matter of title number S-667963
of Security Title and Guaranty Company and are legally used as a single
family residence.
2. That there is no Certificate of Occupancy to be
produced since this was a certified pre-existing use prior to the advent
of zoning within the Township of Southold, that date being the year 1957
3. That there have been no alterations or added
construction to said premises which would affect the legality of such use
as it existed prior to zoning within/~e Township.
Carl H. Schneider, Executor of the
Estate of Helen W. Comiskey
Sworn to before this
day of August, 1981
M~RILYN $. R~M$~UER
NOTARY PU~UC, NaM of New York
NO. 52.4507~24
~alit~d~SuffolkCou~W,~.~
Te~ ExpiresMarch
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